Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Section of Genetics, Children's National Medical Center, Washington, DC, USA.
J Inherit Metab Dis. 2018 Mar;41(2):157-168. doi: 10.1007/s10545-017-0111-x. Epub 2017 Nov 20.
Propionic acidemia (PA) is a classical inborn error of metabolism with high morbidity that results from the inability of the propionyl-CoA carboxylase (PCC) enzyme to convert propionyl-CoA to methylmalonyl-CoA. PA is inherited in an autosomal recessive fashion due to functional loss of both alleles of either PCCA or PCCB. These genes are highly conserved across evolutionarily diverse species and share extensive similarity with pcca-1 and pccb-1 in the nematode, Caenorhabditis elegans. Here, we report the global metabolic effects of deletion in a single PCC gene, either pcca-1 or pccb-1, in C. elegans. Animal lifespan was significantly reduced relative to wild-type worms in both mutant strains, although to a greater degree in pcca-1. Mitochondrial oxidative phosphorylation (OXPHOS) capacity and efficiency as determined by direct polarography of isolated mitochondria were also significantly reduced in both mutant strains. While in vivo quantitation of mitochondrial physiology was normal in pccb-1 mutants, pcca-1 deletion mutants had significantly increased mitochondrial matrix oxidant burden as well as significantly decreased mitochondrial membrane potential and mitochondrial content. Whole worm steady-state free amino acid profiling by UPLC revealed reduced levels in both mutant strains of the glutathione precursor cysteine, possibly suggestive of increased oxidative stress. Intermediary metabolic flux analysis by GC/MS with 1,6-C-glucose further showed both PCC deletion strains had decreased accumulation of a distal tricarboxylic acid (TCA) cycle metabolic intermediate (+1 malate), isotopic enrichment in a proximal TCA cycle intermediate (+1 citrate), and increased +1 lactate accumulation. GC/MS analysis further revealed accumulation in the PCC mutants of a small amount of 3-hydroxypropionate, which appeared to be metabolized in C. elegans to oxalate through a unique metabolic pathway. Collectively, these detailed metabolic investigations in translational PA model animals with genetic-based PCC deficiency reveal their significantly dysregulated energy metabolism at multiple levels, including reduced mitochondrial OXPHOS capacity, increased oxidative stress, and inhibition of distal TCA cycle flux, culminating in reduced animal lifespan. These findings demonstrate that the pathophysiology of PA extends well beyond what has classically been understood as a single PCC enzyme deficiency with toxic precursor accumulation, and suggest that therapeutically targeting the globally disrupted energy metabolism may offer novel treatment opportunities for PA.
Two C. elegans model animals of propionic acidemia with single-gene pcca-1 or pccb-1 deletions have reduced lifespan with significantly reduced mitochondrial energy metabolism and increased oxidative stress, reflecting the disease's broader pathophysiology beyond a single enzyme deficiency with toxic precursor accumulation.
丙酸血症(PA)是一种经典的代谢性遗传病,发病率高,是由于丙酰辅酶 A 羧化酶(PCC)酶无法将丙酰辅酶 A 转化为甲基丙二酰辅酶 A 而导致的。由于 PCCA 或 PCCB 的两个等位基因功能丧失,PA 呈常染色体隐性遗传。这些基因在进化上差异很大的物种中高度保守,并与线虫秀丽隐杆线虫中的 pcca-1 和 pccb-1 有广泛的相似性。在这里,我们报告了单个 PCC 基因(pcca-1 或 pccb-1)缺失在秀丽隐杆线虫中的全局代谢影响。与野生型线虫相比,两种突变株的动物寿命都明显缩短,尽管 pcca-1 突变株的寿命缩短更为明显。通过分离线粒体的直接极谱法测定,线粒体氧化磷酸化(OXPHOS)能力和效率也明显降低。虽然 pccb-1 突变体的体内线粒体生理学定量正常,但 pcca-1 缺失突变体的线粒体基质氧化剂负担显著增加,线粒体膜电位和线粒体含量显著降低。通过超高效液相色谱法对整虫稳态游离氨基酸进行分析显示,两种突变株的谷胱甘肽前体半胱氨酸水平均降低,可能提示氧化应激增加。通过 1,6-C-葡萄糖进行 GC/MS 的中间代谢通量分析进一步表明,两种 PCC 缺失菌株的三羧酸(TCA)循环代谢中间产物(+1 苹果酸)的积累减少,近端 TCA 循环中间产物(+1 柠檬酸)的同位素富集增加,+1 乳酸积累增加。GC/MS 分析进一步显示,PCC 突变体中积累了少量的 3-羟基丙酸,通过独特的代谢途径,它似乎在秀丽隐杆线虫中代谢为草酸盐。总的来说,这些对具有遗传 PCC 缺陷的翻译丙酸血症模型动物进行的详细代谢研究揭示了它们在多个水平上能量代谢的显著失调,包括线粒体 OXPHOS 能力降低、氧化应激增加和远端 TCA 循环通量抑制,最终导致动物寿命缩短。这些发现表明,PA 的病理生理学远远超出了经典上理解的单一 PCC 酶缺乏症和有毒前体积累,并且表明靶向全球失调的能量代谢可能为 PA 提供新的治疗机会。
两种具有单个 pcca-1 或 pccb-1 缺失的秀丽隐杆线虫丙酸血症模型动物的寿命缩短,线粒体能量代谢显著降低,氧化应激增加,反映了疾病的病理生理学超出了单一酶缺乏症和有毒前体积累的范围。